40's male with #Emery-Dreifuss-dystrophy presents with recur | Figure 1

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Case Overview

40's male with #Emery-Dreifuss-dystrophy presents with recurrent VT. AICD present, severe dilated cardiomyopathy, EF 23%. On Pronestyl drip with recurrent VT-over 20 shocks administered in one day. Needs heart transplant. Notwithstanding, would the MD affect his new heart?

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A 72 y/o woman presented to ED with palpitation. She had a history of left ventricular systolic dysfunction for the last 3 years. This is a wide complex tachycardia (WCT). In case of WCT, differential diagnosis should be made between ventricular tachycardia (VT), supraventricular tachycardia with aberrancy and Pre-excited tachycardia. The followings enabled us to diagnose VT.
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  1. Initial q wave >40 msec in aVR ( Vereckei aVR criteria for VT).\
  2. Right bundle branch block morphology in V1 and rS in V6 ( Brugada morphology criteria for VT). If this were a supraventricular tachycardia with a right bundle branch block aberrancy, then we would see "qRs" in V6, not rS! So this is VT in RBBB morphology! #cardiopaedia


A good example of why third degree heart block is so dangerous - it's propensity for inducing polymorphic VT. #VT #polymorphic #thirddegree #heartblock


Preexcitation or VT? Pt presented with chest pain, palpitations. Seems non-adherent with meds.


Beautiful slow/stable VT on one of my hospice patients admitted while in cardiac ICU. pt w/end stage CHF & recurrent VT. VT was controlled with lidocaine, but returned when lido off. Pt AAOx3 and chose to turn off AICD and d/c lido. 18 hours after lido d/c pt having frequent runs in 240s, but still AAO & comfortable.

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Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?